Job Description

Strength Through Diversity
Ground breaking science. Advancing medicine. Healing made personal. 
Patient Financial Services - Req. 2407102
Job Title: Pre-Certification Counselor
Roles & Responsibilities:
  • The Pre-Certification Counselor interacts daily with patients, payers, and clinical staff to ensure that services are financially cleared prior to service provision.  Responsible for the financial screening and counseling for services provided in Hospital Based (Article 28) departments for both the technical and professional components.  This includes ensuring all required demographic, financial, referrals, authorizations and other registration data are collected prior to treatment, verified and communicated appropriately.
  • Responsible for the insurance verification for all encounters for both the hospital and physician.
  • Referral coordination, pre-certification, pre-authorization and benefit screening.  Maintains updates of outcome through multiple systems.
  • Responsible for the drug authorizations and financial verifications, as well as tracking authorization counts and re-authorizing as required by each payer. 
  • Responsible for notification to patients on all out of pocket expenses and working with the front desk to ensure collection of co-payments prior to treatment. Assists patients with any state/federal/pharmacy assistance programs to help cover treatment costs.
  • Utilizes various eligibility systems and websites to obtain benefits, must be able to interpret all coding.  Contacts various payers and physician offices to obtain authorizations, benefits and referrals.
  • Ensures all required demographic, financial, referral/authorization, clinical and other registration data is collected, verified, inputted and communicating appropriately with patient.

  • Education: HS/GED;  Associates Degree preferred
  • Experience:  1 year Hospital/Physician practice experience or billing experience preferred.
  • Knowledge of health insurance payer requirements a plus. 
Strength Through Diversity
The Mount Sinai Health System believes that diversity is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education and advancement as we revolutionize medicine together.
We work hard to acquire and retain the best people, and to create a welcoming, nurturing work environment where you can develop professionally. We share the belief that all employees, regardless of job title or expertise, can make an impact on quality patient care. 
Explore more about this opportunity and how you can help us write a new chapter in our story! 
Who We Are
Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.
Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.
The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation. 
EOE Minorities/Women/Disabled/Veterans
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